Tourniquet self-application assessment in cold weather conditions

Area of Science:

• Emergency Medicine
• Trauma Care
• Wilderness Medicine

Background:

• Assessing civilian self-application of extremity tourniquets (ETs) in challenging cold-weather environments is crucial for wilderness survival.
• Evaluating ET effectiveness over insulating clothing is vital for remote expeditions.

Purpose of the Study:

• To evaluate the ability of nonmedical civilians to self-apply various extremity tourniquets in cold weather.
• To determine the effectiveness of self-applied tourniquets for vascular occlusion under these conditions.

Main Methods:

• A field study involved 37 participants at a Spanish Antarctic base.
• Participants self-applied five commercial tourniquets (CAT, OMNA, RMT, SWAT-T, RATS) over cold-weather gear.
• Effectiveness for vascular occlusion and ease of application were assessed using single-handed (upper extremity) and two-handed (lower extremity) techniques.

Main Results:

• Most tourniquets (except SWAT-T) were effectively self-applied to the upper extremity using a single-handed technique.
• All five tourniquets were correctly self-applied to the lower extremity using a two-handed technique.
• The OMNA tourniquet was rated highest for ease of application on both extremities; the CAT tourniquet was the most preferred device.

Conclusions:

• Nonmedical civilians can successfully self-apply extremity tourniquets in cold weather, even with gloves and technical clothing, after basic training.
• The OMNA and CAT tourniquets demonstrated high ease of application and user preference, respectively, in simulated Antarctic conditions.